Possible Ruptured/torn Cranial Cruiciate Ligament

[maggiespet]

You should, if you haven't already, take her to a board certified orthpedic vet.

 

When I took my dog in, it took him less than 3 minutes to determine, by manipulating my dog's leg, that the ACL was completely gone.

 

It must not be a total tear if he's suggesting all these tests because apparently if it's ruptured, the "knee" moves in ways that simply aren't possible when the ligament is intact.

She was seen by the orth guy at the practice. He came from a gi-normous referral/specialty hospital. But I really don't know why he would ever think/say that it's ruptured, as in completely torn, because she certainly has use of her leg.

 

What we are talking about is a greyhound. Regardless of being conformationally predisposed or not, surgery, like a full tear causes more exertion on the opposite ACL than resting a partial tear and allowing it to heal naturally. Surgery to repair an incomplete tear neither speeds recovery, nor reduces risk. It's also a larger risk for other injuries due to the delicate balance of sighthound locomotion.

And so what do I do? Any other suggestions. The dr. who saw her is a surgeon, so of course he's assuming the only road to recovery is through surgery. Maybe - but I still want to see what another x-ray would look like after the inflammation is down. Even if it shows a definite tear, at least we'd know what we're working with.

[brindlehound]

I'm glad Maggie is doing well.

 

Hang in there little girl and listen to the doctor and your mommy.

 

Magic has a message for Miss Maggie:

[tbhounds]

Most crucitate injury's are diagnosed by radiographs performed under sedation. The seds allow the pet to be completely relaxed so the joint can be manipulated and checked for a draw (extra foward to back unnatural movement).

Even partial tears may made need surgery as eventually the ligament will completely tear making the knee (stifle) completely unstable. Unlike tendons, ligaments will not heal so, without surgery the stifle will eventually "scar down". The scarring will somewhat stablize the joint but, you"ll end up with a very arthritic joint.

Edited September 9, 2011 by tbhounds

[45MPHK9]

Just seeing this, Jane. No medical advice for you. Just wanted to let you know that we are thinking of Miss Maggie.

[JJNg]

Sometimes a surgical repair is necessary, but it's not without complications of it's own (commonly a tear of the opposite ACL)

Just wanted to point out that tearing the opposite cruciate ligament is not a complication of surgery.

 

What we are talking about is a greyhound. Regardless of being conformationally predisposed or not, surgery, like a full tear causes more exertion on the opposite ACL than resting a partial tear and allowing it to heal naturally. Surgery to repair an incomplete tear neither speeds recovery, nor reduces risk. It's also a larger risk for other injuries due to the delicate balance of sighthound locomotion.

Cases where I would consider a surgical repair to be "necessary" are ones with a complete tear with the dog being mostly non-weight bearing to toe-touching on the leg consistently. In these cases, the dog usually isn't any more lame after surgery (sometimes even better), so there wouldn't be increased exertion on the other leg post-op. Along this line of reasoning, if simply increased exertion causes CCL tears, then greys who have a rear leg amputated would be predisposed to CCL tears in their remaining rear leg. In my experience, this doesn't seem to be a common problem in tripod greys.

 

But I really don't know why he would ever think/say that it's ruptured, as in completely torn, because she certainly has use of her leg.

The term "ruptured" can refer to either a partial or complete tear. And some dogs will use the leg even with complete tears, although there is usually a significant lameness. As tbhounds mentioned, partial tears can easily become complete tears. And ligaments don't tend to heal well, just scar down. But even with surgery, the joint will become arthritic, probably just not as fast or as badly.

 

My personal criteria for whether or not to do surgery is based on how bad the lameness is. If the lameness is fairly mild and intermittent, then I think it's fine to treat conservatively and hold off on surgery. For more severe lameness and palpable instability of the joint, surgery is usually the best way to go.

[Guest Swifthounds]

And so what do I do? Any other suggestions. The dr. who saw her is a surgeon, so of course he's assuming the only road to recovery is through surgery. Maybe - but I still want to see what another x-ray would look like after the inflammation is down. Even if it shows a definite tear, at least we'd know what we're working with.

 

Second opinion. If he's a competent board cert. ortho surgeon, he should be able to give a more definitive answer either through manipulation or with x rays under sedation. Oh, and not all surgeons want to cut first and ask questions later.

 

One of the reasons I skip the regular vet and opt for the specialty referral is the convenience of a second (or third) opinion.

[Guest Swifthounds]

Along this line of reasoning, if simply increased exertion causes CCL tears, then greys who have a rear leg amputated would be predisposed to CCL tears in their remaining rear leg. In my experience, this doesn't seem to be a common problem in tripod greys.

 

Not unless it's a really stupid greyhound. They usually figure out that they don't have an amputated leg pretty quickly. Totally different situation than having a leg there to have to support and attempt to use.

[Guest LindsaySF]

It sounds like it's a partial tear if she's weight-bearing and pretty functional. In a complete tear, or a severe partial tear, I think they recommend surgery. A more minor tear can heal on its own. I agree with KennelMom, definitely lots of rest, and leash walking ONLY. Even once you think it's healed, give it longer.

 

Diana's dog Ali (do a search for her posts) has a partial Achilles tendon tear. A friend of ours designed a custom splint for her, and I think it's helping stabilize the leg (and preventing hyper-extension while it heals). Maybe a splint would help? I don't know.

 

 

 

~Lindsay~

[brindlehound]

How did Miss Maggie make out with her x-rays yesterday? Magic and I continue to send good wishes.

[maggiespet]

They had 3 emergencies in a row and needed to reschedule us. Next week is crazy for me so I'm trying to move around my work schedule - because after school schedule is way tighter! She continues to be limp-free and her usual sassy self. But leash walked, carried up and down deck stairs to the yard and not allowed to jump up on the furniture. And she is so pissed at me - I've hidden all my shoes. The vet who is going to look at these x-rays is still on vacation till 10/10. Thanks for asking Carol. Smooches to Magic.